Support Better Reporting of Disease Outbreaks, Vaccine Exemptions

TMA Testimony by Ryan Van Ramshorst, MD 

House Public Health Committee
House Bill 2474 by Rep. J.D. Sheffield, DO

March 24, 2015

Good morning, Madame Chair and distinguished members. My name is Dr. Ryan Van Ramshorst. I am here today to speak in support of House Bill 2474 by Representative J.D. Sheffield. I am a pediatrician in San Antonio, Texas. I am here today on behalf of TMA, TPS, and the many health organizations that are part of the Texas Public Health Coalition. 

As you know, there has been much public debate this year over the issue of vaccine exemptions after the significant measles outbreak in Disneyland. We are not here today to debate the right of anyone to obtain an exemption. Instead, physicians support HB 2474 because it will increase public awareness of state’s infectious disease trends and alert parents to the infectious disease threats their children may face in the schools they choose to attend.  As pediatricians, my colleagues and I are entrusted by parents to help protect their children’s health because children are often the most vulnerable to diseases and environmental threats. Providing access to immunizations for vaccine-preventable diseases is a priority of every physician caring for a child. And thanks to public health and medicine working together, vaccine-preventable diseases are at or near record lows. But the diseases we work to prevent are serious, and underimmunized or unimmunized individuals create a potential for outbreaks of disease. 

We support the requirement in HB 2474 for the Department of State Health Services (DSHS) to complete more comprehensive epidemiological reports of disease outbreaks, including the incidence of vaccine-preventable diseases. We have found that other states’ health departments have been able to provide the public and health care professionals timely information on vaccine-preventable outbreaks by geographic area. This is not information parents, physicians, or others can routinely access in Texas. We believe increasing the public’s awareness of preventable diseases and also of emerging or re-emerging diseases would be extremely valuable. While some of us fortunately reside in areas with the benefit of strong reporting from our local health department, many physicians can rely only on anecdotal information from our physician colleagues to learn of infectious disease or foodborne outbreaks in our community. We believe stronger state-level reporting will also encourage more quality and timely monitoring and reporting from local areas.  

HB 2474 will also require stronger public reporting of immunization exemptions. We recognize the need for immunization exemptions for medical contraindications (as identified by the Centers for Disease Control and Prevention), but there has been a significant increase in conscientious vaccination exemptions since 2003 in our state. This increase makes it even more critical that parents and the community be readily informed of conscientious vaccination objections on their school campuses. This is especially true for parents of children with auto-immune deficiencies or diseases that limit their ability to receive a vaccination.  

While we have a good process for school district reporting on vaccination exemptions and DSHS tracking, this information is only at a district level, which is of limited benefit to families evaluating their schooling options.  Parents must be able to make informed decisions so they know what they may have to do to protect their children in the event of a school-based infectious disease outbreak. These reports will serve as tools for becoming best informed, and also will enable the public health community and physicians to respond in the event of an outbreak.  

We thank Dr. Sheffield, Representative Miller and Representative Blanco for their work in identifying strong public health policies to inform the public and physicians on how we can all be better informed. We urge you to support House Bill 2474, and thank you for your time.

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